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以患者为中心的医疗之家:联邦支持模式如何最大限度减少农村地区老年人的医疗服务可及性差距

Patient-Centered Medical Homes: How the Federally Supported Model Minimizes Healthcare Access Disparities for Older Adults in Rural Areas.

作者信息

Childs Elisa M, Mowbray Orion

机构信息

University of Georgia, Athens, GA, USA.

出版信息

Inquiry. 2025 Jan-Dec;62:469580251335809. doi: 10.1177/00469580251335809. Epub 2025 Jun 26.

Abstract

The federal United States government supports the Patient-Centered Medical Home (PCMH) model to improve American's access to quality healthcare. Healthcare access in the Southern United States is especially problematic given its high rurality, hospital closure rate, number of medically underserved areas, and older adult population. This study explored older adults' ability to obtain health services and PCMHs' impact on reducing healthcare access disparities in rural areas. Adults 65 and older were surveyed using a modified version of the Commonwealth Fund's Health Care Quality Survey (N = 746). Analyses included -test, ANOVA, crosstabulation, chi-square, and multiple linear regression. A significant relationship was found between healthcare access and care source, with PCMH users more likely to report access than persons with a regular care source. PCMH use was also significantly associated with gender, age, income, urban-rural status, health status, and local healthcare quality satisfaction. PCMH accreditors should target rural areas with high rates of older adults, poverty, chronic disease, and poor healthcare quality to minimize healthcare disparities.

摘要

美国联邦政府支持以患者为中心的医疗之家(PCMH)模式,以改善美国人获得优质医疗服务的机会。鉴于美国南部农村地区比例高、医院关闭率高、医疗服务欠缺地区数量多以及老年人口多,该地区的医疗服务可及性尤其成问题。本研究探讨了老年人获得医疗服务的能力以及PCMH对减少农村地区医疗服务可及性差距的影响。使用英联邦基金医疗保健质量调查的修改版对65岁及以上的成年人进行了调查(N = 746)。分析包括t检验、方差分析、交叉表、卡方检验和多元线性回归。研究发现医疗服务可及性与医疗服务来源之间存在显著关系,使用PCMH的人比有常规医疗服务来源的人更有可能报告能够获得医疗服务。使用PCMH也与性别、年龄、收入、城乡状况、健康状况和当地医疗保健质量满意度显著相关。PCMH认证机构应将目标对准老年人口比例高、贫困、慢性病和医疗保健质量差的农村地区,以尽量减少医疗差距。

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